If your child has fever....Information for Parents

What is fever?

Fever occurs when the body's internal "thermostat" raises the body temperature above its normal level. This thermostat is found in the part of the brain called the hypothalamus.The hypothalamus knows what temperature your body should be (usually around 98.6 degrees Fahrenheit, or about 37 degrees Celsius) and will send messages to your body to keep it that way.

Most people's body temperatures even change a little bit during the course of the day: It's usually a little lower in the morning and a little higher in the evening and can fluctuate as kids run around, play, and exercise.

Sometimes, though, the hypothalamus will "reset" the body to a higher temperature in response to an infection, illness, or some other cause. So, why does the hypothalamus tell the body to change to a new temperature? Researchers believe turning up the heat is the body's way of fighting the germs that cause infections and making the body a less comfortable place for them.

Causes of Fever:

t's important to remember that by itself fever is not an illness - it's usually a symptom of an underlying problem. Fever has several potential causes:

Infection: Most fevers are caused by infection or other illness. Fever helps the body fight infections by stimulating natural defense mechanisms.

Overbundling:Infants, especially newborns, may get fevers if they're overbundled or in a hot environment because they can't regulate their body temperature.

Immunizatio: Babies and children sometimes get a low-grade fever after getting vaccinated.

Although teething may cause a slight rise in body temperature, it's probably not the cause if your baby's or toddler's temperature is higher than 100 degrees Fahrenheit (37.8 degrees Celsius).

Should I call a doc?

In the past, doctors advised treating a fever on the basis of temperature alone. But now, they recommend taking both the temperature and the child's overall condition into account.

Children whose temperatures are lower than 102 degrees Fahrenheit (38.9 degrees Celsius) usually don't require medication, unless they're uncomfortable. There's one important exception to this rule: If you have an infant 3 months or younger with a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, call your baby's doctor or go to the emergency department. Even a slight fever can be a sign of a potentially serious infection in very young infants.

For older children, take behavior and activity level into account. By watching how your child behaves, you can get a pretty good idea as to whether he or she has a minor illness or needs to be seen by a doctor.

The illness is probably not serious if your child:

• is still interested in playing
• is eating and drinking well
• is alert and smiling at you
• has a normal skin color
• looks well when his or her temperature comes down

And don't worry too much about a child with a fever who doesn't want to eat. This is very common with infections that cause fever.

How will I know if my child has fever?

A gentle kiss on the forehead or a hand placed lightly on your child's skin is often enough to tell that your child has a fever. However, this method of taking a temperature (called tactile temperature) is dependent on the person doing the feeling and doesn't give an accurate measure of a child's temperature.

By using a reliable thermometer, you can tell if your child has a fever if his or her temperature is at or higher than one of the following levels:

• 100.4 degrees Fahrenheit (38 degrees Celsius) measured rectally (in the bottom)
• 99.5 degrees Fahrenheit (37.5 degrees Celsius) measured orally (in the mouth)
• 99 degrees Fahrenheit (37.2 degrees Celsius) measured in an axillary position (under the arm)

But how high a fever is doesn't tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102 to 104 degrees Fahrenheit, or 38.9 to 40 degrees Celsius, range), but doesn't usually indicate a serious problem. And serious infections may cause no fever or even an abnormally low body temperature, especially in young infants.

Because fevers may rise and fall, a child with fever may experience chills, which occur when the body tries to generate additional heat when the body's temperature begins to rise. The child may sweat as the body releases extra heat when the temperature starts to drop.

Sometimes children with a fever may also breathe faster than usual and may have a higher heart rate. You should call your child's doctor if your child is having difficulty breathing, is breathing a lot faster than normal, or continues to breathe fast after the fever comes down.

Please call your doctor if:

The exact temperature that should trigger a call to the doctor depends on the age of the child, the illness, and whether the child has other symptoms with the fever.

Call your child's doctor if you have an:

• infant younger than 3 months with a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius)
• older child with a temperature of higher than 104 degrees Fahrenheit (40 degrees Celsius)

If an older child has a fever of less than 104 degrees, call the doctor if the child also:

• refuses fluids or seems too ill to drink adequately
• has persistent diarrhea or repeated vomiting
• has any signs of dehydration
• has a specific complaint (i.e., sore throat or earache)
• still has a fever after 24 hours in a child younger than 2 years or 72 hours in a child 2 years or older
• has recurrent fevers, even if they only last a few hours each night

Seek emergency care if your child shows any of the following signs along with a fever:

• inconsolable crying for several hours
• extreme irritability
• lethargy and difficulty waking
• rash or purple spots that look like bruises on the skin (that were not there before the child got sick)
• blue lips, tongue, and nails
• infant's soft spot on the head seems to be bulging outward
• stiff neck
• severe headache
• limpness and refusal to move
• difficulty breathing that doesn't get better when the nose is cleared
• leaning forward and drooling
• seizure
  

Also, check with your child's doctor for his or her specific guidelines on when to call about a fever.